Please keep your promise, rural targeted medical students are prevented from defaulting? Gansu Provincial Health Commission: Repeatedly preaching policy requirements | Policy | Rural | Compliance | Training | Gansu Province | Breach of contract | Medical

"My child has been admitted to the Medical Master's program and has agreed to assume breach of contract liability in accordance with the requirements of targeted medical student performance management. Our parents will repay the full amount of breach of contract liability on our behalf, but relevant departments have clearly prevented the breach. Recently, two messages have appeared on the leadership message board of People's Daily, reflecting the issue of breach of contract by rural targeted medical students in Gansu Province.".

The Gansu Provincial Health Commission later replied that it has repeatedly conveyed national policy requirements and objectives to representatives of students who intend to breach the contract, and has also repeatedly guided and persuaded them to clarify the practical significance of compliance. Recently, the Provincial Health Commission has actively coordinated with relevant departments at the provincial level, as well as the human resources and social security, health and other departments at the city and county levels, focusing on addressing issues such as employment placement and compliance management for targeted medical students. Please advise and guide the child to follow the relevant national policies, abide by the agreement signed by both parties, keep their promises, report to work as soon as possible, make the correct choice that meets the policy requirements and people's expectations, and play their due role in meeting the medical and health needs of rural people in Gansu Province.

Pengpai News noticed that in 2020, the Gansu Provincial Health Commission announced on its official website the list of rural targeted medical students who defaulted on orders from 2015 to 2019. The list shows that in the past five years, 251 rural targeted medical students in Gansu Province have defaulted on orders, and this trend has been increasing year by year. In 2015, the number of defaulters was only 5, and in 2019 it increased to 85. Most of these defaulting students come from clinical medicine majors, with some coming from traditional Chinese medicine majors. From the distribution of schools, 223 graduates from Lanzhou University account for 90% of the list of defaulters, while the remaining 28 come from Gansu University of Traditional Chinese Medicine.

The Lanzhou Daily reported at the time that medical students were unwilling to return to grassroots services, mainly due to issues such as the treatment and career development prospects of grassroots doctors.

In the same year, the General Office of the People's Government of Gansu Province issued the Implementation Opinions on Further Strengthening the Free Training, Employment Placement, and Performance Management of Rural Order oriented Medical Students, requiring all training institutions, standardized training bases for resident physicians, and employers to regard socialist core values, honesty and modern contract spirit as important contents for the training and use of targeted medical students, strengthen ideological education for targeted medical students in advocating integrity, practicing integrity, and other aspects, guide them to strictly abide by relevant regulations and the "Training and Employment Agreement" during their study and service periods, and fulfill their obligation to serve grassroots medical and health institutions in targeted employment service areas for 6 years.

The implementation opinion points out that targeted medical students who do not have legal or agreed justifiable reasons and fail to report to the designated service unit according to the agreed time or work at the designated service unit according to the time required by the county-level health department after graduation shall be deemed to have breached the contract. Targeted medical students are required to refund the training fees and pay a one-time penalty of twice the total amount of the aforementioned fees; If targeted medical students refuse to fulfill their obligations during or after the standardized training for resident physicians, they shall be refunded the training fees and salary benefits they have already enjoyed during the 5-year undergraduate education stage and the standardized training for resident physicians, and shall be calculated at twice the total training fees mentioned above, with a one-time payment of liquidated damages.

In terms of performance integrity management, the Gansu Provincial Health Commission, together with the Provincial Department of Human Resources and Social Security and the Provincial Department of Education, will also announce the list of defaulting students in the province by the end of December each year, and report it to relevant competent departments such as the National Health Commission, the Ministry of Human Resources and Social Security, the Ministry of Education, and the National Administration of Traditional Chinese Medicine. The national competent departments or relevant industry organizations commissioned by them will establish an information sharing mechanism, which will serve as an important basis for the personal integrity evaluation of public recruitment of staff, standardized training for resident physicians, standardized training for specialized physicians, and graduate enrollment in medical and health institutions at all levels.

This implementation opinion indicates that free training of targeted medical students is a major measure to deepen medical reform and strengthen the construction of the general practitioner team. It is a fundamental strategy to improve the overall quality and level of rural grassroots medical and health teams, implement a hierarchical diagnosis and treatment system, promote coordinated development between urban and rural areas, ensure and improve people's livelihoods, and is an organic component of rural revitalization and poverty alleviation work. It is also the main channel for Gansu Province to supplement grassroots health talents at present. Since the implementation of the project in 2010, Gansu Province has recruited a total of 5834 targeted medical students, with a total of 1638 graduates and 1388 job fulfilled obligations. Targeted medical graduates have become a vital force for rural grassroots health talents in Gansu Province, playing an important role in improving the overall diagnosis and treatment capabilities of grassroots medical and health institutions.

Gansu also acknowledges that due to the low cost of breach of contract for targeted medical students, as well as inadequate employment arrangements, job positions, and benefits in some cities, prefectures, counties, and districts, some targeted medical students choose to default after graduation, which affects policy effectiveness.